Wednesday, November 30, 2011

A note to the reader: As always, I have received no remuneration for posting this book review. As a point of disclosure, I did, however, receive a free copy of the book from the author in order to facilitate the review process.

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Dr. Dean Burke, MD is a successful OB/GYN and author who has branded himself as a champion of nurses' financial freedom. Married to a nurse, Dean has an intimate understanding of the challenges and vicissitudes of the nursing profession, and he encourage nurses to leverage his knowledge and advice in the interest of their own financial well-being. Since nurses are so good at caring for others, Dean contends that they should also be just as good at managing their own lives, financially and otherwise.

The Millionaire Nurse is a book and companion website that walk nurses through the basics of financial management, using simple language and understandable examples to illustrate the subject at hand. Dean offers practical advice on a variety of subjects, relating the issues generally to nurses' lives, nurses' income levels, and the challenges that he knows many nurses face in the real world. While money management is foremost in Dean's writings, time management and the enjoyment of life also figure largely in Dean's world of wealth and financial freedom. Dean's writing leans towards the casual, with pithy puns and down-to-earth language not usually found in books about money.

The subjects covered in The Millionaire Nurse include calculating net worth, debt management, homeownership (including buying and selling), budgeting, salaries and benefits, insurance, saving money at home, saving and paying for college, retirement and investing. And while a great deal of this information could be gleaned from any number of books, websites or magazines about finance, none of those sources are written specifically for the nurse, using real-life examples from nurses' lives and data that reflect the reality of those lives.

Dean states in his introduction: "My plan in The Millionaire Nurse is to help you to prioritize and rearrange your financial dreams into reasonable and reachable goals. I also feel it is my duty to give back to you, the nurses who have saved my rear-end more than once."

Whether your financial situation is in need of intensive care, outpatient surgery or emergency resuscitation, Dr. Dean offers no-nonsense advice that I believe is sound, understandable, digestible, and practical. His free downloadable e-book, "Emergency Money Resuscitation", is a very helpful volume, as is his regular email newsletter that is sent periodically to subscribers.

Dean on investing: "Emotional decisions are the enemy of good investing. Just as when you're faced with an extremely ill patient, panicking never helps---especially the patient."

Dean on debt: "One of the most difficult aspects of retiring your debt is taking the ego out of your decisions."

Dean on setting financial goals: "Goals are necessary. In the long run, you'll begin to look forward to setting goals for yourself, not the least because they not only give you direction, they also act as self-fulfilling prophecies."

I recommend "The Millionaire Nurse", whether you plan to be a millionaire or not. We nurses work hard, serve the greater good, and many of us struggle financially like so many others, whether we live here in the United States or abroad. Dr. Dean offers a readable and user-friendly plan that can be shared with friends and family members alike. We should all be committed to our own financial well-being and freedom, and I'm grateful to Dean for caring enough about nurses to create products specifically geared towards our noble and valuable profession.

Tuesday, November 22, 2011

I will begin this review with the disclosure that Publisher Wolters Kluwer contacted me through a marketing agent and requested that I post a review of their new Nursing 2012 Drug Handbook here on Digital Doorway. I did not receive financial compensation of any kind for this review, but did receive a free copy of the guide in order to facilitate the review process.

Upon first glance, the new Nursing2012 Drug Handbook looks like any other drug handbook I have encountered in the past. However, on further inspection I was pleased to see several aspects of this book that are both useful and user-friendly.

Traditionally, nursing drug handbooks utilize a simple alphabetical listing of drugs that allows a nurse to easily use the book as an easy and quick reference tool. This book follows the same format, including new FDA-approved drugs, black box warnings, and other information that a prudent nurse would require and expect.

There are several aspects of this guide that I find especially useful and worthy of notice, and these include:

A color photo guide to "396 tablets and capsules, representing the most commonly prescribed generic and trade name drugs." These are listed alphabetically by generic name, and the photos are shown in actual size and color, with cross-referencing to drug information in other portions of the book.

Each drug entry includes a small table with route, onset, peak duation, and half-life clearly listed.

Overdose information is listed in red.

Look-alike and sound-alike warnings are given for appropriate medications.

The useful appendices include:

Pregnancy risk categories

Controlled substance schedules

Quick guide to combination drugs

Common combination drugs

Vaccines and toxoids: indications and dosages

Vitamins and minerals: indications and dosages

Therapeutic drug monitoring guidelines

Cytochrome P-450 enzymes and common drug interactions

Drugs that prolong QT intervals

Dialyzable drugs

Abbreviations to avoid

Herbal supplements

Drugs that shouldn't be crushed or chewed

Avoiding common drug errors: best practices and prevention

Pediatric drugs commonly involved in drug errors

Elder care medication tips

Additional new drugs: indications and dosages

The purchase of the book also provides the owner with a one-year subscription to Lippincott's online Nursing Drug Advisor, a site that provides online access to monographs of every medication in the text. This access also includes an online toolkit, with a dosage calculator, English-to-Spanish drug phrase translator, tables of equivalents and conversions, and discounted CE programs.

Overall, I am very impressed by the layout of the book, the appendices, and the online content.

Through the publisher, I have several offers to elucidate at this juncture.

The first nurse who leaves a comment on this post will receive a free copy of the book directly from the publisher. (The winner will need to provide me with their mailing address.)

Other nurses who wish to purchase the book can do so via this link, receiving an instant 20% discount as a reader of Digital Doorway. (I receive no remuneration for these purchases, and I am simply passing on these savings to my readers based on an offer from the publisher.)

This book is a worthwhile investment, and I am happy to have my own copy, as well as access to the very useful and user-friendly online resources.

Thursday, November 10, 2011

I am grateful to the good people at LPNtoBSNonline for inviting me to be their new resident "expert blogger". The blog is now live, and you can visit the blog by clicking here. The posts are generally geared towards nurses---both seasoned and novice---and those who wish to enter the field.

Please stop by regularly since there will be two new posts every week!

Tuesday, November 08, 2011

Whenever I tell someone that I’m a nurse, the inevitable
question follows: “So, which hospital do
you work in?”

While I have nothing against hospitals (well, maybe I do!)
or nurses who work in them, I have chosen to forge a nursing career utterly
free of the hospital environment. Although many colleagues assured me that it
was professional suicide to do so, I chose to eschew the one or two years of
Med-Surg that most nurses undergo after graduation, and I entered directly into
community nursing and never looked back.

My History

Over the last 15 years, I’ve worked as a nurse in two urban
community health centers that served low-income Latinos, held a position as a
Nurse Care Manager for several cutting-edge case management programs in the
same low-income urban neighborhoods, worked as a visiting nurse, a hospice
nurse (inpatient and outpatient), as well as a stint as a nursing professor and
as the sole Public Health Nurse for a New England town of 25,000 people. Meanwhile,
I’ve maintained a popular nursing blog, have contributed chapters to several
books about nursing, been interviewed on radio and internet radio, and been
published on a variety of nursing websites as a regular contributor.

Despite my lack of hospital experience, I have never felt
encumbered by a less-than-interesting career or by the sense that something is
missing from that career. Needless to say, if I was to seek a position in a
hospital-based program or unit, I might have to first spend a year or so in
Med-Surg, and that would be fine. Meanwhile, my career is wholly satisfying and
I have never lacked for interesting and remunerative work.

The Public’s
Perception

When someone reflexively asks me what hospital I work in, I
am immediately reminded that the public simply has no real idea what nurses do
and simply base their image of nursing on images from television and the
movies.

If you ask the average American what their image of a nurse
is, they will most likely describe a nurse in scrubs working in a hospital, or
an older American just might conjure up the image of a nurse in starched whites
with a little cap on her head. Those images indeed still persist, despite the
efforts of some in the nursing community to counter that outdated stereotype.

Sadly for us, Nurse Ratched (of “One Flew Over the Cuckoo’s Nest” fame), is probably the most famous
nurse in the American zeitgeist after Florence Nightingale, so many Americans
may either see nurses as crazed sadists armed with arm-length needles or angels
of mercy who serve as a doctor’s handmaiden amidst the horrors of war and
disease.

What Does It All
Mean, Anyway?

The public has a particular perception of nurses that is
skewed by television and the media’s ability to create cultural icons that are
difficult to overcome. It is the mission of many nurses to change that
perception by providing a new paradigm in which nurses are perceived as trained
and competent professionals that work in a variety of clinical settings.

From a personal point of view, I feel it is equally
important for both nurses and the public to understand that, while hospital
nursing is a crucial aspect of the profession, there are scores of nurses who
choose to work in community-based positions that do not involve employment by a
hospital. While some hospital nurses may see non-hospital nurses as somehow
inferior (an erroneous perception that I have personally encountered during my
career), non-hospital based nurses contribute a great deal to society and to
the nursing profession as a whole.

Whose Responsibility
Is It?

Nursing has changed a great deal, especially over the last
100 years, and I believe that it is in the collective interest of all nurses to
take responsibility to mold and recreate the public’s perception of who we are
and what we do, not to mention our own self-perception of the profession.

So, when someone asks me what hospital I work in rather than
simply asking me what kind of nursing I do, I see it as my personal mission to
educate that individual regarding the myriad functions a nurse can perform and
the many environments where that can occur.

Public perception of nurses does not necessarily negate our
efficacy or our importance, but it can indeed impact our self-esteem, our
profession’s standing, as well as the cultural and societal significance of our
work. It’s up to us to educate those around us that nurses are not akin to the nurses
portrayed on television. We are real people doing real work. Nurses make a
difference in people’s lives. We always have, and we always will.

Wednesday, November 02, 2011

Periodically, I receive unsolicited requests by publishers and media agencies to review books here on Digital Doorway. In return for my services, I receive a copy---or several copies---of said tome, and the satisfaction of thinking---and writing---like a critic. There have been a few books that I've decided to not review after having read them since I don't want to hurt the author's feelings, and there are several that have been equally a pleasure to read and to write about.

That said, a number of months ago, I received a request to review "In Stitches: A Memoir" by Dr. Anthony Youn, M.D., one of the most famous cosmetic surgeons in the United States. I did not peruse Youn's many websites until after finishing the book, although based on the personality communicated through the book, I was not surprised to find the sites ranging from significantly tacky to unsurprisingly tacky. The book, co-written with Allan Eisenstock, strives to rise above the glamorous veneer exuded by the websites, and manages to do so from time to time in its more sober moments, but the book is, in the end, a disappointment on many fronts.

In his memoir, Dr. Youn paints a portrait of a young, second-generation Korean-American who grows up in a household ruled by a nearly tryannical father (a successful OB-GYN) who Youn, along with his brother, both fear, respect and obey almost unquestioningly throughout their lives. Developing a jaw deformity as a teenager, Youn undergoes a series of surgeries that we are led to believe have an eventual impact on his decision to become a cosmetic surgeon. Sadly, although he briefly tells the story of his father's family, Youn's parents remain two-dimensional characters, as do most of the other individuals portrayed throughout the book (including his wife-to-be).

Unfortunately, Youn spends dozens of pages reminiscing over his sexual failures and inadequacies in the world of dating and women, and we are treated to multiple stories of the exploits---or lack thereof---of Youn and his adolescent and college-aged friends. This aspect of the book is most painful and tedious, and I found myself sighing in impatient consternation when faced with yet another anecdote about his hopes as a wannabe Romeo being dashed once again.

Youn makes it explicit that his Asian background and cultural heritage account largely for his feelings of being an outsider in a majority caucasian world. To his credit, he often uses self-deprecating humor to his advantage, and he clearly describes a moment in his life when his judgment and derision of another outsider (a gay roommate), causes him great shame and regret.

Still, although Youn rhapsodizes about realizing the errors of his ways and tells us how he has grown as a person through his many trials and tribulations, within this book he manages to propagate and give further power to many misguided notions regarding beauty and outward appearance. And while Youn clarifies that he has become a doctor---specifically a plastic surgeon---because he wants to "fix people", it is no surprise that he has become the "plastic surgeon to the stars", nipping and tucking his way into American living rooms via numerous television appearances.

Just as Dr. Youn refers consistently to women he wants to date as "knockouts" or "Penthouse hot", he demonstrates his judgmental attitudes regarding beauty and "otherness" by referring to an elderly professor as "an old witch" and a neighbor in his college dorm as a "mountain range of hairless flab". Youn could have taken the road less traveled, sharing tea and sympathy with other outcasts and societal rejects, but instead he takes the easy way out and utilizes cliche and occasional self-deprecation as a tool to elicit sympathy for himself while simultaneously attempting to elicit loathing by the reader for those less handsome, less rich, less successful than he wanted to be (and eventually became).

When he is serious and earnest, the author is at his best, as in this passage where, while in gross anatomy lab, he sees the humanity within the cadaverous body parts populating various plastic tubs:

"I drift over to the bodies that we will study, some under tarps, some lying naked, their innards exposed, and certain details that I'd never noticed jump out---tattoos, dental fillings, scars---and I feel lightheaded. I am in awe of these people. Most of all, instead of feeling detached from them, as I assume most doctors do, I feel attached to them. Committed to them.

"I can't say that I feel this way constantly, every second of anatomy class, every moment of medical school. I will often lose this feeling of reverence toward these bodies, especially when I'm grinding through my notes, preparing for an exam. But I'm able to bring myself back, to locate the humanity easily.

"Especially when I look into the bin of hands."

It is in moments like these that Youn's compassion shines through, as when he holds a crying baby all night or convinces a man who feels unloved to have a life-saving surgery.

Youn also uses humor well in certain passages, painting hilarious portraits/caricatures of medical residents, interns, doctors and surgeons that many in the medical field will most likely find highly entertaining and evocative of some of their own experiences.

Over all, Youn's book is a chatty, breezy and lightweight read with a modicum of entertainment value. He offers rather pedestrian and less than insightful advice about medical school, and apparently fails to grasp or elucidate the depths to which he could have plumbed the role of outsider and societal outcast that he managed to only hint at throughout its pages.

As an Asian American from a hardworking upper-middle class family with a father who works as a successful doctor, Youn is not exactly a kid from the other side of the tracks. Still, his theme of being an outsider---a theme driven home ad nauseum in the first half of the book----falls flat based on the life that Youn describes and the relative privilege that he enjoys. Sure, he once had a Thanksgiving meal from a convenience store, but there is no doubt that Youn had his sights set high and managed to achieve his goals, perhaps beyond his wildest dreams. I applaud the author's professional tenacity and his ability to create the life he always wanted, but Youn's attempt at a memoir offers too little in terms of moving passages describing humanity's many frailties, and too much of his sentimental and simplistic summing up of the world according to Anthony Youn.

This memoir is one to read, for example, when waiting in an airport during a long layover, and then leave on the seat for the next weary traveler who needs an unchallenging and moderately entertaining ---yet forgettable---memoir to pass the time.

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